{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T20:17:32Z","timestamp":1783369052707,"version":"3.54.6"},"reference-count":53,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thebreastonline.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Breast"],"published-print":{"date-parts":[[2019,8]]},"DOI":"10.1016\/j.breast.2019.04.005","type":"journal-article","created":{"date-parts":[[2019,4,25]],"date-time":"2019-04-25T19:33:26Z","timestamp":1556220806000},"page":"40-47","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":29,"special_numbering":"C","title":["Pathways to care for patients in Pakistan experiencing signs or symptoms of breast cancer"],"prefix":"10.1016","volume":"46","author":[{"given":"Imran","family":"Hameed Khaliq","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafiz Zahid","family":"Mahmood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Danish","family":"Sarfraz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Masood Gondal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakila","family":"Zaman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.breast.2019.04.005_bib1","series-title":"Noncommunicable diseases and mental health","author":"World Health Organization","year":"2018"},{"issue":"12","key":"10.1016\/j.breast.2019.04.005_bib2","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.1002\/ijc.25516","article-title":"Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008","volume":"127","author":"Ferlay","year":"2010","journal-title":"Int J Cancer"},{"issue":"5","key":"10.1016\/j.breast.2019.04.005_bib3","doi-asserted-by":"crossref","first-page":"E359","DOI":"10.1002\/ijc.29210","article-title":"Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012","volume":"136","author":"Ferlay","year":"2015","journal-title":"Int J Cancer"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib4","doi-asserted-by":"crossref","first-page":"1288773","DOI":"10.1080\/2331205X.2017.1288773","article-title":"Cancer prevalence, incidence and mortality rates in Pakistan in 2012","volume":"4","author":"Sarwar","year":"2017","journal-title":"Cogent Med"},{"key":"10.1016\/j.breast.2019.04.005_bib5","first-page":"804","article-title":"The necessity of awareness of breast cancer amongst women in Pakistan","volume":"59","author":"Khan","year":"2009","journal-title":"J\u00a0Pak Med Assoc"},{"key":"10.1016\/j.breast.2019.04.005_bib6","series-title":"Cancer registry in Pakistan","author":"Pakistan Health Research Council (PHRC)","year":"2018"},{"key":"10.1016\/j.breast.2019.04.005_bib7","series-title":"Cancer country profile. Cancer","author":"World Health Organization","year":"2018"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib8","first-page":"143","article-title":"Comparison of two public sector tertiary care hospitals' management in reducing direct medical cost burden on breast carcinoma patients in Lahore, Pakistan","volume":"23","author":"Hameed","year":"2018","journal-title":"J\u00a0BUON"},{"key":"10.1016\/j.breast.2019.04.005_bib9","series-title":"Health expenditure per capita (current US$)","author":"World Bank","year":"2018"},{"issue":"6","key":"10.1016\/j.breast.2019.04.005_bib10","doi-asserted-by":"crossref","first-page":"28","DOI":"10.2307\/3528451","article-title":"Families, patients, and physicians in medical decisionmaking: a Pakistani perspective","volume":"30","author":"Moazam","year":"2000","journal-title":"Hastings Cent Rep"},{"key":"10.1016\/j.breast.2019.04.005_bib11","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1086\/JCE199809205","article-title":"The family in medical decision making: Japanese perspectives","volume":"9","author":"Fetters","year":"1998","journal-title":"J\u00a0Clin Ethics"},{"issue":"2","key":"10.1016\/j.breast.2019.04.005_bib12","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3390\/diseases4020017","article-title":"Women's Views on Handling and managing their breast cancer in Pakistan: a qualitative study","volume":"4","author":"Naz","year":"2016","journal-title":"Diseases"},{"key":"10.1016\/j.breast.2019.04.005_bib13","series-title":"Economics Survey of Pakistan","author":"Government of Pakistan","year":"2018"},{"issue":"2","key":"10.1016\/j.breast.2019.04.005_bib14","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1093\/ecam\/neh088","article-title":"Complementary and alternative medicine in Pakistan: prospects and limitations","volume":"2","author":"Shaikh","year":"2005","journal-title":"Evid Based Complement Alternat Med"},{"issue":"5","key":"10.1016\/j.breast.2019.04.005_bib15","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1177\/1049732307299994","article-title":"Cancer patients' negotiation of therapeutic options in Pakistan","volume":"17","author":"Tovey","year":"2007","journal-title":"Qual Health Res"},{"key":"10.1016\/j.breast.2019.04.005_bib16","series-title":"Cancer staging","author":"American Cancer Society","year":"2018"},{"issue":"23","key":"10.1016\/j.breast.2019.04.005_bib17","first-page":"28","article-title":"Household costs of breast cancer morbidity: an empirical assessment from Pakistan","volume":"Suppl","author":"Mahmood","year":"2018","journal-title":"J\u00a0BUON"},{"key":"10.1016\/j.breast.2019.04.005_bib18","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1038\/bjc.2012.68","article-title":"The Aarhus statement: improving design and reporting of studies on early cancer diagnosis","volume":"106","author":"Weller","year":"2012","journal-title":"Br J Canc"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib19","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1111\/coa.12919","article-title":"The length of patient and primary care time interval in the pathways to treatment in symptomatic oral cancer. A quantitative systematic review","volume":"43","author":"Varela-Centelles","year":"2018","journal-title":"Clin Otolaryngol"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib20","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1186\/s12885-015-1317-7","article-title":"Diagnostic intervals before and after implementation of cancer patient pathways\u2013a GP survey and registry based comparison of three cohorts of cancer patients","volume":"15","author":"Jensen","year":"2015","journal-title":"BMC Canc"},{"issue":"11","key":"10.1016\/j.breast.2019.04.005_bib21","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1037\/a0032721","article-title":"Prospective impact of illness uncertainty on outcomes in chronic lung disease","volume":"32","author":"Hoth","year":"2013","journal-title":"Health Psychol"},{"key":"10.1016\/j.breast.2019.04.005_bib22","series-title":"Health system profile Pakistan","year":"2007"},{"issue":"2","key":"10.1016\/j.breast.2019.04.005_bib23","first-page":"251","article-title":"The politics of Sufism: redefining the saints of Pakistan","volume":"42","author":"Ewing","year":"1983","journal-title":"J\u00a0Asian Stud"},{"issue":"2","key":"10.1016\/j.breast.2019.04.005_bib24","first-page":"177","article-title":"A\u00a0survey of medicinal plants used by the traditional medicinal practitioners of Khulna City, Bangladesh","volume":"5","author":"Akber","year":"2011","journal-title":"Am-Eurasian J Sustain Agric"},{"issue":"2","key":"10.1016\/j.breast.2019.04.005_bib25","first-page":"129","article-title":"Homeopathy","volume":"18","author":"Bayley","year":"1993","journal-title":"J\u00a0Med Philos"},{"issue":"12","key":"10.1016\/j.breast.2019.04.005_bib26","first-page":"1145","article-title":"Homeopathy. An overview","volume":"29","author":"Ballard","year":"2000","journal-title":"Aust Fam Physician"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib27","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/1475-9276-11-60","article-title":"The financial burden of cancer: estimates from patients undergoing cancer care in a tertiary care hospital","volume":"11","author":"Zaidi","year":"2012","journal-title":"Int J Equity Health"},{"issue":"9","key":"10.1016\/j.breast.2019.04.005_bib28","first-page":"905","article-title":"Psychosocial impact of cancer on adult patients","volume":"62","author":"Rashid","year":"2012","journal-title":"J\u00a0Pak Med Assoc"},{"key":"10.1016\/j.breast.2019.04.005_bib29","series-title":"Health services","author":"Government of Punjab","year":"2018"},{"issue":"2","key":"10.1016\/j.breast.2019.04.005_bib30","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1258\/jhsrp.2011.010113","article-title":"The Andersen Model of Total Patient Delay: a systematic review of its application in cancer diagnosis","volume":"17","author":"Walter","year":"2012","journal-title":"J\u00a0Health Serv Res Policy"},{"issue":"7","key":"10.1016\/j.breast.2019.04.005_bib31","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1634\/theoncologist.2014-0493","article-title":"Delays in breast cancer presentation and diagnosis at two rural cancer referral centers in Rwanda","volume":"20","author":"Pace","year":"2015","journal-title":"Oncol"},{"issue":"5","key":"10.1016\/j.breast.2019.04.005_bib32","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1093\/eurpub\/ckt131","article-title":"Delays in diagnosis and treatment of breast cancer: a multinational analysis","volume":"24","author":"Jassem","year":"2013","journal-title":"Eur J Public Health"},{"key":"10.1016\/j.breast.2019.04.005_bib33","series-title":"Global information technology report 2016","author":"Baller","year":"2016"},{"key":"10.1016\/j.breast.2019.04.005_bib34","series-title":"Literacy among youth is rising, but young women lag behind","author":"UNICEF Data","year":"2015"},{"issue":"10","key":"10.1016\/j.breast.2019.04.005_bib35","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.jfma.2012.12.003","article-title":"Delayed time from first medical visit to diagnosis for breast cancer patients in Taiwan","volume":"113","author":"Shieh","year":"2014","journal-title":"J\u00a0Formos Med Assoc"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib36","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1038\/sj.bjc.6604096","article-title":"Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic review","volume":"98","author":"Mitchell","year":"2008","journal-title":"Br J Canc"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib37","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1186\/s12885-016-2394-y","article-title":"Factors influencing diagnosis delay of advanced breast cancer in Moroccan women","volume":"16","author":"Maghous","year":"2016","journal-title":"BMC Canc"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib38","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/cncr.28287","article-title":"Breast cancer presentation and diagnostic delays in young women","volume":"120","author":"Ruddy","year":"2014","journal-title":"Cancer"},{"issue":"3","key":"10.1016\/j.breast.2019.04.005_bib39","first-page":"288","article-title":"Presentation delay in breast cancer patients and its association with sociodemographic factors in North Pakistan","volume":"27","author":"Khan","year":"2015","journal-title":"Chin J Canc Res"},{"issue":"4","key":"10.1016\/j.breast.2019.04.005_bib40","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/NCC.0b013e31819b240f","article-title":"The impact of culture and sociological and psychological issues on Muslim patients with breast cancer in Pakistan","volume":"32","author":"Banning","year":"2009","journal-title":"Cancer Nurs"},{"issue":"6","key":"10.1016\/j.breast.2019.04.005_bib41","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.canep.2013.09.018","article-title":"Patient navigation pathway and barriers to treatment seeking in cancer in India: a qualitative inquiry","volume":"37","author":"Pati","year":"2013","journal-title":"Cancer Epidemiol"},{"issue":"2","key":"10.1016\/j.breast.2019.04.005_bib42","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1006\/pmed.1996.0049","article-title":"Reasons for delay in breast cancer diagnosis","volume":"25","author":"Caplan","year":"1996","journal-title":"Prev Med"},{"issue":"7","key":"10.1016\/j.breast.2019.04.005_bib43","first-page":"662","article-title":"Late presentation of breast cancer: a Dilemma","volume":"61","author":"Talpur","year":"2011","journal-title":"J\u00a0Pak Med Assoc"},{"issue":"7","key":"10.1016\/j.breast.2019.04.005_bib44","first-page":"1","article-title":"Determinants of patient delay in doctor consultation in head and neck cancers (Protocol DEREDIA)","volume":"4","author":"Christophe","year":"2014","journal-title":"BMJ"},{"issue":"6","key":"10.1016\/j.breast.2019.04.005_bib45","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1634\/theoncologist.2011-0469","article-title":"The effect of age on delay in diagnosis and stage of breast cancer","volume":"17","author":"Partridge","year":"2012","journal-title":"Oncol"},{"key":"10.1016\/j.breast.2019.04.005_bib46","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1038\/bjc.2017.127","article-title":"Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records","volume":"116","author":"Mounce","year":"2017","journal-title":"Br J Canc"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib47","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5588\/pha.14.0066","article-title":"Patient delay in the diagnosis and treatment of tuberculosis in China: findings of case detection projects","volume":"5","author":"Lin","year":"2015","journal-title":"Public Health Action"},{"key":"10.1016\/j.breast.2019.04.005_bib48","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1111\/j.1365-3156.2007.01953.x","article-title":"How affordable are tuberculosis diagnosis and treatment in rural China? An analysis from community and TB patient perspectives","volume":"12","author":"Liu","year":"2007","journal-title":"Trop Med Int Health"},{"issue":"8","key":"10.1016\/j.breast.2019.04.005_bib49","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1093\/oxfordjournals.aje.a117719","article-title":"System delay in breast cancer in whites and blacks","volume":"142","author":"Caplan","year":"1995","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.breast.2019.04.005_bib50","series-title":"A\u00a0study of the health seeking behavior of women on treatment for cervical cancer in Grey's hospital","author":"Adejumo","year":"2018"},{"issue":"1","key":"10.1016\/j.breast.2019.04.005_bib51","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1468-0432.2008.00434.x","article-title":"\u2018Live to work \u2019or \u2018work to live\u2019? A qualitative study of gender and work\u2013life balance among men and women in mid-life","volume":"16","author":"Emslie","year":"2009","journal-title":"Gend Work Organ"},{"issue":"2","key":"10.1016\/j.breast.2019.04.005_bib52","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/sj.bjc.6605384","article-title":"Do diagnostic delays in cancer matter?","volume":"101","author":"Neal","year":"2009","journal-title":"Br J Canc"},{"issue":"2","key":"10.1016\/j.breast.2019.04.005_bib53","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.bjoms.2015.11.003","article-title":"Role of general practice in the diagnosis of oral cancer","volume":"54","author":"Crossman","year":"2016","journal-title":"Br J Oral Maxillofac Surg"}],"container-title":["The Breast"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0960977619304928?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0960977619304928?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T08:41:05Z","timestamp":1760776865000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0960977619304928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":53,"alternative-id":["S0960977619304928"],"URL":"https:\/\/doi.org\/10.1016\/j.breast.2019.04.005","relation":{},"ISSN":["0960-9776"],"issn-type":[{"value":"0960-9776","type":"print"}],"subject":[],"published":{"date-parts":[[2019,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Pathways to care for patients in Pakistan experiencing signs or symptoms of breast cancer","name":"articletitle","label":"Article Title"},{"value":"The Breast","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.breast.2019.04.005","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}